Pregnancy outcome in systemic lupus erythematosus complicated by anti-phospholipid antibodies

Rheumatology (Oxford). 2009 Mar;48(3):246-9. doi: 10.1093/rheumatology/ken458. Epub 2008 Dec 24.


Objective: Pregnant women affected by SLE are at high risk of gestational hypertension and pre-eclampsia (32-50%). This risk is particularly elevated if aPLs are dosable. The present study was planned to evaluate maternal-fetal outcomes of different groups of SLE pregnant patients characterized by diverse risk factors: patients affected by APS treated with a combination of low-dose aspirin (LDA) and low-molecular weight heparin (LMWH), nulliparous patients with dosable aPL treated by LMWH and SLE patients with no aPL administered no treatment during pregnancy.

Methods: A retrospective description of maternal and fetal outcomes was made in a total of 62 pregnancies presenting APS in 8 cases (12.9%), aPL in 20 (32.2%) and no aPL in 34 (54.8%).

Results: No statistically significant difference was found comparing fetal and maternal outcomes of the three groups despite differences in SLE activity: SLE aPL-positive pregnancies were associated with a higher incidence of nephritis and chronic hypertension than pregnancies treated for APS or not presenting with the added risk factor. The incidence of pre-eclampsia is 15% in aPL positive, 12.5% in APS and 14.7% in no aPL pregnancies, respectively.

Conclusions: LMWH is rather a possible option of prophylaxis for SLE aPL-positive pregnancies with potential maternal-fetal outcomes similar to aPL-negative patients or to standard treated APS.

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use
  • Antiphospholipid Syndrome / complications*
  • Antiphospholipid Syndrome / drug therapy
  • Female
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Lupus Erythematosus, Systemic / complications*
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Pregnancy Outcome
  • Retrospective Studies


  • Anticoagulants
  • Heparin, Low-Molecular-Weight